PRP clinic Chandler: blood-based care explained

What to try before making an appointment

Move the joint gently, but stop before the soreness rises sharply. Also stop when the ache lasts well after the activity. Shorter walks or lighter lifting can settle a flare, and steady exercise may strengthen nearby muscles. Some knees also feel steadier in a brace.

Warmth may loosen a stiff joint after waking; cold may reduce swelling later in the day. Protect your skin with a cloth around either pack. Ask your doctor which medicine is safe beside your current medicines.

Daily movement should become easier with home care, rather than steadily more difficult.

When to have the soreness checked

Book an exam once soreness limits sleep, walking, work, or use of your arm. Go sooner when swelling stays or the joint buckles. The clinician checks where it hurts, then tests the joint's range of movement. An X-ray may show wear or damage from an earlier injury.

Consultations at QC Kinetix can cover regenerative treatments, meaning care made with material taken from you. After the exam, the clinician may include PRP among the choices. The visit covers your health, the sore tissue, costs, and other care. PRP won't fit every joint or every person.

What the exam shows helps match the care to your soreness.

When to get help without waiting

Get prompt care for a hot, red joint that swells fast, especially when you also feel feverish or sick. Quick help also matters when a limb changes shape or suddenly becomes weak. If movement stops after a sharp pop, a tendon may have torn.

These problems need an urgent exam, so they can't wait for a PRP visit booked for later.

For common soreness, take your medicines and earlier X-ray reports to the visit. Name the activity you hope to do more easily, such as walking farther or raising your arm.

Sources

1. The devices used to spin PRP at the point of care are cleared by FDA as clinical centrifuges, product code JQC, a Class I device under 21 CFR 862.2050 - for example the Biomet GPS Platelet Separation Kit (K030555, cleared 2003) and the Harvest SmartPrep2 / SmartPrep Platelet Concentration System (K103340, cleared 2010). That clearance covers the equipment that separates blood. It is not an FDA approval of platelet-rich plasma as a treatment for osteoarthritis, tendinopathy or any other orthopedic condition, and copy must never blur the two.

   U.S. Food and Drug Administration (Center for Devices and Radiological Health) — 510(k) Premarket Notification database and Product Classification: JQC, Centrifuges (Micro, Ultra, Refrigerated) For Clinical Use, 21 CFR 862.2050. FDA accessdata (CDRH device databases), 2003.

2. In the RESTORE trial - the largest placebo-controlled PRP trial in knee osteoarthritis - 288 adults aged 50+ with symptomatic Kellgren-Lawrence grade 2-3 medial knee OA received three weekly intra-articular injections of leukocyte-poor PRP from a commercial system or saline placebo. At 12 months the mean change in knee pain was -2.1 points with PRP versus -1.8 with saline (difference -0.4; 95% CI -0.9 to 0.2; P=.17) against a minimum clinically important difference of 1.8, and the change in medial tibial cartilage volume was -1.4% versus -1.2% (difference -0.2%; 95% CI -1.9% to 1.5%; P=.81). Twenty-nine of 31 prespecified secondary outcomes showed no significant between-group difference. The authors concluded the findings do not support use of PRP for knee OA.

   Bennell KL, Paterson KL, Metcalf BR, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

3. A meta-analysis of 18 Level I randomized trials (811 patients receiving PRP, 797 receiving hyaluronic acid, mean follow-up 11.1 months) found mean improvement in total WOMAC scores was significantly higher with PRP (44.7%) than with hyaluronic acid (12.6%) (P<.01), and 6 of 11 VAS-reporting studies found significantly less pain with PRP at latest follow-up.

   Belk JW, Kraeutler MJ, Houck DA, et al. — Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. American Journal of Sports Medicine, 2021. DOI: 10.1177/0363546520909397.

4. A systematic review of 105 clinical PRP studies in orthopaedics published 2006-2016 found that only 11 (10%) described the preparation protocol clearly enough for another investigator to repeat it, and only 17 (16%) reported any quantitative metric of the final PRP composition. The authors concluded that the current reporting of PRP preparation and composition does not allow the PRP products actually delivered to patients to be compared between studies.

   Chahla J, Cinque ME, Piuzzi NS, et al. — A Call for Standardization in Platelet-Rich Plasma Preparation Protocols and Composition Reporting: A Systematic Review of the Clinical Orthopaedic Literature. Journal of Bone and Joint Surgery (American), 2017. DOI: 10.2106/JBJS.16.01374.